Provider Demographics
NPI:1699703371
Name:SAINT ALPHONSUS PHYSICIAN SERVICES INC
Entity type:Organization
Organization Name:SAINT ALPHONSUS PHYSICIAN SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:FRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-367-7270
Mailing Address - Street 1:6533 W EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8737
Mailing Address - Country:US
Mailing Address - Phone:208-367-4197
Mailing Address - Fax:208-367-8136
Practice Address - Street 1:6533 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8737
Practice Address - Country:US
Practice Address - Phone:208-367-4197
Practice Address - Fax:208-367-8136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine